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Objectives: This study investigated the development of German psychotherapy trainees in professional, relational, and personal competence.  Methods:  The study followed a naturalistic pre–post design over 3 years and included a control group of non-trainee psychologists. The sample consisted of 219 participants, including 64 cognitive–behavioral trainees, 120 psychodynamic trainees and 35 control participants. Outcomes were knowledge (multiple choice exam), case-formulation competence (Case Formulation Content Coding Method), healing and stressful involvement (Therapist Work Involvement Scales), attributional complexity (Attributional Complexity Scale), introject affiliation, and affiliation in patient treatments (Intrex questionnaire). Multilevel Modeling was used to investigate change over time and group by time interactions. Comparisons to the control group were limited to knowledge, case-formulation competence, and attributional complexity.  Results : Trainees improved in knowledge, case-formulation competence, healing involvement, and affiliation in treatments with small to medium effects. There was no change in stressful involvement, attributional complexity or introject affiliation. According to reliable change indices, the majority of trainees did not change reliably. Over time, trainees outperformed the control group only in case-formulation competence. There were several main and group by time effects regarding trainee orientation.  Conclusions : Results imply benefits of training on professional and relational competence but only limited effects on personal competence.

The competence development of German psychotherapy trainees: A naturalistic, longitudinal and multidimensional outcome study